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Hepatitis, Canine Infectious 454.e3

• Management of hypoglycemia: intravenous Recommended Monitoring • A routine initial series followed by a
glucose 0.5 g/kg IV bolus (= 1 mL 50% For the acute phase: booster at 1 year and then every 3-5 years
VetBooks.ir tion, must be diluted with sterile water by neurologic status, coagulation times, blood Technician Tips Diseases and Disorders
• Vital parameters, body weight, mental and
is recommended.
dextrose/kg body weight; before administra-
at least 50% to avoid phlebitis/perivascular
glucose, albumin
irritation), followed by 2.5%-5% dextrose
infused in balanced electrolyte solution For chronic hepatitis: • Puppies with acute, fulminant ICH require
intensive nursing care, and even with the
• Serum chemistry panel and, if anicteric,
• Lactulose 0.5-1 mL/kg PO q 8h for animals serum bile acids best treatment, mortality rates are high.
exhibiting neurologic signs (p. 440) • Repeat liver biopsy 6 months after starting • Due to the infectious nature of the disease,
treatment confirmed or suspected cases should be
Chronic Treatment handled with strict precautions to prevent
For more information on treatment of ongoing PROGNOSIS & OUTCOME nosocomial infection of other animals.
hepatitis, see Chronic Hepatitis (pp. 450 and Luckily, most vaccinated pets resist infection.
452). • Prognosis for acute, fulminant infection is
• Diet: protein-restricted diet for animals with grave: animals often die within hours. SUGGESTED READING
hepatic encephalopathy. All other animals • Mortality rate: 10%-30% Greene CE: Infectious canine hepatitis and canine
should be given a high-carbohydrate, • Long-term prognosis for chronic hepatitis acidophil cell hepatitis. In Greene CE, editor:
moderate-fat and protein diet. Dietary secondary to CAdV-1 is guarded. Infectious diseases of the dog and cat, ed 4, St.
fiber has been shown to bind bile acids and ○ Animals with hypoalbuminemia, hypo- Louis, 2012, Saunders, pp 42-48.
aid in their removal; psyllium powder 1-3 glycemia, and coagulopathies usually die
teaspoons/day (5-15 mL/day) can be added within 1 week of diagnosis. ADDITIONAL SUGGESTED
to the diet. READINGS
• Prednisone or prednisolone 1 mg/kg PO q PEARLS & CONSIDERATIONS Boomkens SY, et al: Hepatitis with special reference
12-24h. After clinical improvement, the dose to dogs. A review on the pathogenesis and infectious
is tapered to 0.5 mg/kg q 24h, then q 48h. Comments etiologies, including unpublished results of recent
The use of prednisone for chronic hepatitis What was once a common and often fatal own studies. Vet Q 26:107-114, 2004.
is controversial. infection has become rare in the United States Decaro N, et al: Canine adenoviruses and herpesvirus.
• Vitamin E 50-400 IU/DOG PO q 24h due to routine vaccination of pet dogs. Vet Clin North Am Small Anim Pract 38:799-814,
• S-Adenosylmethionine (SAMe) 20 mg/ 2008.
kg PO q 24h; silybin-phosphatidylcholine Prevention
complex 20-70 mg/kg PO q 24h (Denamarin • Routine vaccination (DHLPP or DHPP) RELATED CLIENT EDUCATION
Advanced per package directions) provides protection against infectious canine SHEET
hepatitis along with distemper, leptospirosis
Drug Interactions parvovirus, and parainfluenza. Consent to Administer Vaccinations, Canine
May need to decrease dosages for drugs metabo- • Modified live vaccine with CAdV-2 isolates AUTHOR: Mauria A. O’Brien, DVM, DACVECC
lized by the liver in acute liver injury phase is used for preventing infectious canine EDITOR: Joseph Taboada, DVM, DACVIM
hepatitis. The CAdV-2 MLV vaccine confers
Possible Complications cross-protection and has fewer side effects
Pyelonephritis, disseminated intravascular (corneal edema, fever) compared with the
coagulation, glaucoma CAdV-1 vaccine.

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